http://www.wjhl.com/local/addiction-psychiatrist-questions-involuntary-tapering-of-opioids/943940749
JOHNSON CITY, TN (WJHL) – A renowned author and addiction psychiatrist says the efforts of the Department of Veterans Affairs and other institutions across the country to taper people off opioids without their consent is “an outrage.”
“To take a patient who’s doing well off of medication abruptly and without their permission is not unfair. I actually think it’s malpractice,”
Dr. Sally Satel said. “I think it is an outrage when you have a person who’s doing well on a dose of medication, highly functional and their pain is under good control. This is what you want. This is the clinical outcome.”
Dr. Satel is a resident scholar at the American Enterprise Institute and a lecturer at Yale University. She’s a vocal opponent of the involuntary tapering of controlled opioids.
“It shouldn’t be done without their permission,” she said. “Without the patient’s consent, the results are often disasterous.”
Mountain Home VA Medical Center is prescribing half as many opioids as it did in 2012, according to recently released federal data. Since December 2016, several veterans have voiced their frustration over what they’ve said is a mandate to taper their pain medications.
Dr. Satel says many institutions have misinterpreted the Centers for Disease Control’s pain management guidelines as mandates rather than recommendations.
“It doesn’t say anything about taking people off their medications if they don’t want to go off of it,” Dr. Satel said. “Of course, it’s frustrating, especially when it’s misinterpreted in the direction of poor patient care. It’s very frustrating.”
For decades, VA and other doctors have prescribed pain medications because they thought, at the time, that’s what patients needed. However, in recent years, they changed their approach when new research found opioids can be dangerous and ineffective.
“I understand their fear, their anxiety and their anger, but I want them to understand this is driven by our concern for their safety,” Mountain Home VA Opiate Safety Initiative Chairman Dr. Martin Eason said in December 2016.
Most recently, Mountain Home VA Chief of Staff Dr. David Hecht said the facility is proud of its 49% decrease in opioid prescriptions since 2012. He added, doctors consider every patient’s need on a case-by-case basis and taper veterans off opioids in a safe way.
“Many veterans have really understood and bought into it and it has helped us,” Dr. Hecht said. “Any time we reduce these medications, we want to reduce them in a safe environment.”
The VA maintains it has taken patients off opioids gradually and given veterans the opportunity to appeal their tapering decisions. The agency adds while opioids may help with short-term pain, they are not approved to treat chronic pain in non-cancer patients. Mountain Home is now encouraging veterans to try safer and more effective alternatives.
As we reported earlier this month, VA representatives plan to discuss preliminary data that show a link between opioid discontinuation and suicides at an upcoming summit. Dr. Satel has authored several published works alongside one of those speakers.
Filed under: General Problems
If the CDC “guideline” for opioid prescribing physicians is “supposed” to be voluntary with patient input and agreement, then WHY were pain management specialists REQUIRED to attend meetings in their area of practice by DEA “officials” and TOLD “do NOT prescribe” over the dosage calculated as per the CDC conversion chart of all opioid medications into an “equivalent” of no more than 90 or 100 milligrams of morphine. I KNOW that meetings by DEA “officials” were in FACT mandated for opioid prescribing physicians and FEAR to exceed the CDC guidline was instilled so efficiently that NO physicians with a DEA number will prescribe over the maximum “suggested” dosage by the CDC misguidedline! This WHY ALL physicians are in fear of license revocation, license “surrender” state medical boards are calling it. The DEA IS definitely creating fear and have ACTED causing physicians to “surrender” their licenses! This is an unknown fact by pain management patients and the general public. The “guideline” is NOT a “suggestion” and the DEA has gone rogue! I can not devulge how I know these meetings have taken place across this country for fear of my own that I could harm someones career. If CDC claims that the patient must be a “willing” participant to attempt to lower personal dosage then, I DO NOT AGREE! This D “misguideline” has cost me my business, my life savings, endangered my health with complications from un managed pain now, and it is NOTHING short of Gestapo tactics by DEA. Yes, I realize their is a substance abuse situation in this country but to blame ALL pain managment patients and MAKE our physicians reduce all of us that exceed the suggested dosage set by CDC, it is NOT reducing substance abuse overdose even with MILLIONS less opioid medications issued since the start of 2016 and the overdose rate continues to rise even with “tapered” reduction of dosages of medication that is documented by our doctors to be effective, non harmful, and enabled some 10 million patients for years and decades that are WELL documented. Can you say …..DEA Gestapo??
Since Mountain Home VA Medical center reduced their opioid prescribing by almost half in six year’s does that mean they will be held accountable for over prescribing( in their opioion) for all the previous years? Funny how they change the rules in the middle of the game and screw everyone else and still come out smelling like a rose.
Many veterans huh